MEDICARE: C A RYAN ENTERPRISES LIMITED LIABILITY COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1366393589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C A RYAN ENTERPRISES LIMITED LIABILITY COMPANY

Provider Business Mailing Address
First Line	:	455 BISCAYNE BAY BND
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-3160
Country	:	US
Telephone Number	:	512-367-2597
Fax Number	:

Provider Business Practice Location Address
First Line	:	455 BISCAYNE BAY BND
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-3160
Country	:	US
Telephone Number	:	512-367-2597
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHARLIE A RYAN
Credential	:
Telephone Number	:	512-367-2597

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/13/2026

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